Class instructor Joe Mizda (right) helps John Merrill fill out an online form for a deer license during a class to help senior citizens with social media and computers Thursday in this 2014 photo. Credit: Ashley L. Conti | BDN

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For weeks, images of empty city streets, deserted airports, and vacant subways have saturated the nightly news, chilling reminders of this pandemic’s reach. But now, as we’re hearing of plans to re-open the economy, it’s more important than ever to recognize that it’s not just cities feeling the effects. Rural communities, which make up about 20 percent of the U.S. population, are also reeling from its impacts, and these effects may be both more costly and longer lasting.

As a researcher studying rural education, I’ve been in touch with rural educators and leaders across Maine and the country throughout this crisis. While they’ve adopted innovative strategies to cope with its effects, their challenges are significant — and, right now, mostly overlooked. But as rural rates of infection begin to equal and surpass urban rates, these needs will only grow more acute.

[Our COVID-19 tracker contains the most recent information on Maine cases by county]

Perhaps the largest challenge is the rural health care system. Many rural areas lack hospitals, doctors, and critical-care units. Since 2010, 106 hospitals have closed in the rural U.S., and another 700 are at risk of closure. Those that remain open often face shrinking budgets and staff shortages.

Moreover, many rural residents have underlying conditions, related to age or dangerous working conditions, that put them at higher risk of complications due to the coronavirus. Already-unstable rural health care systems may be pushed to a breaking point by COVID-19.

We also entered this crisis with a much-discussed, little-acted-on digital divide: While nearly 97 percent of urban residents have access to high-speed fixed service, only 65 percent of rural residents do. This divide has long hampered rural growth — and, now, with most students and employees expected to work from home, it’s also compromising daily learning and productivity.

In response, some service providers have worked to quickly expand their reach, but uneven rural terrain makes this expansion difficult. Rural superintendents are ordering hotspots, but they are back-ordered — and also costly for increasingly tenuous budgets.

Communities are developing their own responses, too, like circulating lists of businesses with publicly accessible hotspots that extend into parking lots. However, residents without transportation or far from town are still left without access.

Another issue that the pandemic has exacerbated is food insecurity. Nearly 13 percent of rural households are food insecure, and more than three-quarters of the counties with the highest levels of food insecurity are rural. Across the country, though, food banks — an important tool for mitigating hunger — are facing unprecedented shortages, and rural pantries are running low, too.

Many rural schools are packing meals for families to pick up or running buses to deliver food, though reaching all families remains a challenge, especially in large, sparsely populated districts. Regional School Unit 10, for example, is distributing hundreds of non-perishable meals a day to delivery points across its 478-square mile district — but officials know that many parents have neither the time nor the transportation to retrieve them.

Finally, many rural areas are contending with an information gap: a shortage of trustworthy information about the pandemic. Many rural households rely on their local newspapers for their news, yet about a quarter of local papers nationwide have closed since 2004.

And, as advertisers pull ads, the pandemic is making this gap worse: In rural Nevada, for example, six rural weekly papers have recently scaled back production or closed entirely. This leaves many residents with little knowledge of current CDC guidelines or local and state orders, which could lead to inflated infection rates. Some rural leaders also cite rising racism, fueled by a lack of understanding about the pandemic’s origins.

Right now, what rural communities need most is access: to health care, to the internet, to food, to information. This access will help mitigate the worst effects of an already deadly crisis. But what is particularly frustrating about this moment is that these inequalities were identified long before now. We entered this crisis with policymakers and industries well-aware of both their causes and their impacts.

We need to act now. We need to ensure that, as we work to staff more critical-care units and expand digital access and fill the shelves of food banks and provide reliable information, we’re not just doing so in our cities.

Rural residents are cobbling together stop-gap responses, watching online lessons from parked cars and meeting school buses for bags of sandwiches. But these are temporary solutions. Our 60 million rural residents also need the help of policymakers to fix these longstanding access issues. Because after this pandemic is over and we’re on our way to “recovery,” that crisis will remain.

Mara Casey Tieken is an associate professor of education at Bates College.